Policy & Regulation News

Senate will vote on ICD-10 delay, SGR fix on Monday

March 28, 2014 - According to official Democratic Congressional floor news, the Senate has reached an agreement to vote on HR 4302 on the evening of Monday, March 31. The bill provides for a temporary patch to the Medicare sustainable growth rate (SGR), repealing the planned 24% reduction in reimbursements slated to take place on April 1, 2014, and also includes language delaying the implementation of ICD-10 for at least one year and extending the controversial “two-midnight” rule. The bill was voted through the House of Representatives on March 27.

The Senate agreement to vote on the bill is as follows:

Following Leader remarks on Monday, March 31, the Senate proceed to the consideration of HR 4302, which was received from the House and is at the desk; that there be no amendments or motions in order to the bill with the exception of budget points of order and the applicable motions to waive; that the time until 5PM be equally divided between the two Leaders, or their designees, for debate on the bill; that notwithstanding the previous order, following the vote on confirmation of the Owens nomination on Monday, March 31st, the Senate resume consideration of HR 4302, the bill be read a third time and the Senate proceed to vote on passage of the bill; that the bill be subject to a 60 affirmative vote threshold.

While industry stakeholders would prefer a permanent fix to the hated SGR formula, most are in favor of passing the temporary measure as a necessary stopgap to prevent a disastrous drop in Medicare reimbursement rates. HR 4302 includes a .5% update through December 31, 2014 and a zero percent update from January 1, 2015 through March 31, 2015.

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More unexpected, however, is Section 212 of the legislation, which would prohibit HHS from implementing ICD-10 at any point before October 1, 2015. While an additional delay would give providers more time to test their systems, upgrade software, and prepare their staff members for the requirements of the new code sets, the bill comes less than six months before the deadline the industry had been expecting. The abrupt turnaround will no doubt cause a great deal of consternation at CMS, which has been urging providers to adhere to the October 1, 2014 deadline for months, and may be disruptive to providers, health plans, and other stakeholders who have been pushing hard to make the cut.